Нормализация массы тела и улучшение гликемического контроля у пациента с сахарным диабетом 2-го типа на фоне терапии агонистом рецепторов глюкагоноподобного пептида-1 дулаглутидом под контролем флеш-мониторинга: клинический случай
Скуридина Д.В., Демидова Т.Ю., Перетятько А.Б. Нормализация массы тела и улучшение гликемического контроля у пациента с сахарным диабетом 2-го типа на фоне терапии агонистом рецепторов глюкагоноподобного пептида-1 дулаглутидом под контролем флеш-мониторинга: клинический случай. FOCUS Эндокринология. 2021; 4: 49–57. DOI: 10.47407/ef2021.2.4.0049
Skuridina D.V., Demidova T.Yu., Peretyatko A.B. Normalization of body weight and improvement of glycemic control in a patient with type 2 diabetes mellitus during therapy an agonist of glucagon-like peptide-1 dulaglutide under the control of flash monitoring: clinical case. FOCUS Endocrinology. 2021; 4: 49–57. DOI: 10.47407/ef2021.2.4.0049
Управление сахарным диабетом 2-го типа является многокомпонентной задачей в клинической практике. Цели лечения не останавливаются на достижении целевого уровня гликированного гемоглобина. Адекватный гликемический контроль с приближением вариабельности глюкозы к показателям таковой у здорового человека, контроль липидного профиля и артериального давления, назначение современных препаратов, влияющих на сердечно-сосудистые риски, снижение избыточной массы тела в комплексе позволяют значительно по влиять на качество и продолжительность жизни наших пациентов. Современный подход диктует нам необходимость детальной оценки гликемического профиля, которая стала возможна благодаря системам непрерывного мониторинга глюкозы. В данном клиническом случае представлены пример воздействия на факторы риска при помощи назначения препарата из группы агонистов рецепторов глюкагоноподобного пептида-1, пример коррекции терапии на основании данных флеш-мониторирования глюкозы крови.
Ключевые слова: сахарный диабет 2-го типа, ожирение, агонист рецепторов глюкагоноподобного пептида-1, дулаглутид, непрерывный мониторинг глюкозы.
Ключевые слова: сахарный диабет 2-го типа, ожирение, агонист рецепторов глюкагоноподобного пептида-1, дулаглутид, непрерывный мониторинг глюкозы.
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2. Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterol-ogy 2007; 132 (6): 2131–57. DOI: 10.1053/j.gastro.2007.03.054
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[Telnova ME, Petunina NA. Evaluation of glucagon-like peptide-1 level indi-cator in persons with obesity basal and in the courseof alimentary load. Meditsinskiy vestnik MVD. 2014; 4: 41–5 (in Russian)].
9. Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterol-ogy. 2007; 132 (6): 2131–57. DOI: 10.1053/j.gastro.2007.03.054
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14. Tuttle KR, Lakshmanan MC, Rayner B et al. Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate-to-severe chronic kidney disease (AWARD-7): a multicentre, open-label, randomised trial. Lancet Diabetes Endocrinol 2018; 6 (8): 605–17. DOI: 10.1016/S2213-8587(18)30104-9
15. ClinicalTrials.gov [Internet]. The effect of dulaglutide on major cardiovas-cular events in patients with type 2 diabetes: Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND). (NCT01394952) https://clinicaltrials.gov/ ct2/show/NCT01394952
16. Ferdinand KC, Botros FT, Atisso CM, Sager PT. Cardiovascular safety for once-weekly dulaglutide in type 2 diabetes: a pre-specified meta-analysis of prospectively adjudicated cardiovascular events. Cardiovasc Diabetol 2016; 15: 38. DOI: 10.1186/s12933-016-0355-z
17. Tuttle KR, McKinney TD, Davidson JA et al. Effects of once-weekly dulaglu-tide on kidney function in patients with type 2 diabetes in phase II and III clinical trials. Diabetes Obes Metab 2017; 19 (3): 436–41. DOI: 10.1111/dom.12816
18. Matfin G, Van Brunt K, Zimmermann AG et al. Safe and Effective Use of the Once Weekly Dulaglutide Single-Dose Pen in Injection-Naive Patients With Type 2 Diabetes. J Diabetes Sci Technol 2015; 9 (5): 1071–9. DOI: 10.1177/1932296815583059
19. Diabetes Control and Complications Trial Research Group. The effect of in-tensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes melli- tus. N Engl J Med 1993; 329: 977–86.
20. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphony- lureas or insulin compared with conventional treat-ment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.
21. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with met- formin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352: 854–65.
22. Diabetes Control and Complications Trial/Epidemiology of Diabetes Inter-ventions and Complications Research Group, Lachin JM, Genuth S, Cleary P et al. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 2000; 342: 381–9.
23. Writing Team for the Diabetes Control and Com- plications Trial/Epidemi-ology of Diabetes Interven- tions and Complications Research Group. Effect of intensive therapy on the microvascular complica- tions of type 1 diabetes mellitus. JAMA 2002; 287: 2563–9.
24. Diabetes Control and Complications Trial (DCCT)/ Epidemiology of Dia-betes Interventions and Com- plications (EDIC) Study Research Group. In-tensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: the DCCT/EDIC study 30-year fol- low-up. Diabetes Care 2016; 39: 686–93.
25. Kovatchev BP. Metrics for glycaemic control: from HbA1c to continuous glu-cose monitoring. Nat Rev Endocrinol 2017; 13: 425–36.
26. Brazg RL, Klaff LJ, Parkin CG. Performance vari- ability of seven commonly used self-monitoring of blood glucose systems: clinical considerations for patients and providers. J Diabetes Sci Technol 2013; 7: 144–52.
27. Hirsch IB, Verderese CA. Professional flash continuous glucose monitoring with ambulatory glucose profile reporting to supplement A1C: rationale and practical implementation. Endocr Pract 2017; 23: 1333–44.
2. Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterol-ogy 2007; 132 (6): 2131–57. DOI: 10.1053/j.gastro.2007.03.054
3. Chia CW, Egan JM. Role and development of GLP-1 receptor agonists in the management of diabetes. Diabetes Metab Syndr Obes 2009; 2: 37–49. DOI: 10.2147/DMS0.S4283
4. Цыганкова О.В., Веретюк В.В., Аметов А.С. Инкретины сегодня: мно-жественные эффекты и терапевтический потенциал. Сахарный диабет. 2019; 22 (1): 70–8. DOI: 10.14341/DM9841
[Tsygankova O.V., Veretiuk V.V., Ametov A.S. Inkretiny segodnia: mnozh-estvennye effekty i terapevticheskii potentsial. Sakharnyi diabet. 2019; 22 (1): 70–8. DOI: 10.14341/DM9841 (in Russian)].
5. ClinicalTrials.gov [Internet]. The effect of dulaglutide on major cardiovas-cular events in patients with type 2 diabetes: Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND). (NCT01394952). https://clinicaltrials.gov/ ct2/show/NCT01394952
5. Weinstock RS, Guerci B, Umpierrez G et al. Safety and efficacy of once-weekly dulaglutide versus sitagliptin after 2 years in metformin-treated pa-tients with type 2 diabetes (AWARD-5): a randomized, phase III study. Dia-betes Obes Metab 2015; 17 (9): 849–58. DOI: 10.1111/dom.12479
6. Ferdinand KC, White WB, Calhoun DA et al. Effects of the once-weekly glucagon-like peptide-1 receptor agonist dulaglutide on ambulatory blood pressure and heart rate in patients with type 2 diabetes mellitus. Hypertension 2014; 64 (4): 731–7. DOI: 10.1161/HYPERTENSIONAHA. 114.03062
7. Eli Lilly and Company. Dulaglutide (Trulicity) approved product information [Internet]. Available from: http:// uspl.lilly.com/trulicity/trulicity.html#pi
8. Тельнова М.Э., Петунина Н.А. Оценка показателя уровня глюкагоно-подобного пептида-1 при ожирении базально и в ходе теста с пище-вой нагрузкой. Медицинский вестник МВД. 2014; 4: 41–5.
[Telnova ME, Petunina NA. Evaluation of glucagon-like peptide-1 level indi-cator in persons with obesity basal and in the courseof alimentary load. Meditsinskiy vestnik MVD. 2014; 4: 41–5 (in Russian)].
9. Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterol-ogy. 2007; 132 (6): 2131–57. DOI: 10.1053/j.gastro.2007.03.054
10. Weinstock RS, Guerci B, Umpierrez G et al. Safety and efficacy of once-weekly dulaglutide versus sitagliptin after 2 years in metformin-treated pa-tients with type 2 diabetes (AWARD-5): a randomized, phase III study. Dia-betes Obes Metab 2015; 17 (9): 849–58. DOI: 10.1111/dom.12479
11. Umpierrez G, Tofé Povedano S, Pérez Manghi F et al. Efficacy and safety of du-laglutide monotherapy versus metformin in type 2 diabetes in a randomized controlled trial (AWARD-3). Diabetes Care. 2014; 37 (8): 2168–76. DOI: 10.2337/dc13-2759
12. Wysham C, Blevins T, Arakaki R et al. Efficacy and safety of dulaglutide added onto pioglitazone and metformin versus exenatide in type 2 diabetes in a randomized controlled trial (AWARD-1). Diabetes Care 2014; 37 (8): 2159–67. DOI: 10.2337/dc13-2760
13. Pozzilli P, Norwood P, Jodar E et al. Improved glycemic control and weight loss with once weekly dulaglutide versus placebo, both added to titrated daily insulin glargine, in type 2 diabetes patients (AWARD-9). Diabetes 2016; 65 (Suppl. 1): A62. [abstract 237-OR] DOI: 10.2337/db16-1-381
14. Tuttle KR, Lakshmanan MC, Rayner B et al. Dulaglutide versus insulin glargine in patients with type 2 diabetes and moderate-to-severe chronic kidney disease (AWARD-7): a multicentre, open-label, randomised trial. Lancet Diabetes Endocrinol 2018; 6 (8): 605–17. DOI: 10.1016/S2213-8587(18)30104-9
15. ClinicalTrials.gov [Internet]. The effect of dulaglutide on major cardiovas-cular events in patients with type 2 diabetes: Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND). (NCT01394952) https://clinicaltrials.gov/ ct2/show/NCT01394952
16. Ferdinand KC, Botros FT, Atisso CM, Sager PT. Cardiovascular safety for once-weekly dulaglutide in type 2 diabetes: a pre-specified meta-analysis of prospectively adjudicated cardiovascular events. Cardiovasc Diabetol 2016; 15: 38. DOI: 10.1186/s12933-016-0355-z
17. Tuttle KR, McKinney TD, Davidson JA et al. Effects of once-weekly dulaglu-tide on kidney function in patients with type 2 diabetes in phase II and III clinical trials. Diabetes Obes Metab 2017; 19 (3): 436–41. DOI: 10.1111/dom.12816
18. Matfin G, Van Brunt K, Zimmermann AG et al. Safe and Effective Use of the Once Weekly Dulaglutide Single-Dose Pen in Injection-Naive Patients With Type 2 Diabetes. J Diabetes Sci Technol 2015; 9 (5): 1071–9. DOI: 10.1177/1932296815583059
19. Diabetes Control and Complications Trial Research Group. The effect of in-tensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes melli- tus. N Engl J Med 1993; 329: 977–86.
20. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphony- lureas or insulin compared with conventional treat-ment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837–53.
21. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with met- formin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352: 854–65.
22. Diabetes Control and Complications Trial/Epidemiology of Diabetes Inter-ventions and Complications Research Group, Lachin JM, Genuth S, Cleary P et al. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 2000; 342: 381–9.
23. Writing Team for the Diabetes Control and Com- plications Trial/Epidemi-ology of Diabetes Interven- tions and Complications Research Group. Effect of intensive therapy on the microvascular complica- tions of type 1 diabetes mellitus. JAMA 2002; 287: 2563–9.
24. Diabetes Control and Complications Trial (DCCT)/ Epidemiology of Dia-betes Interventions and Com- plications (EDIC) Study Research Group. In-tensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: the DCCT/EDIC study 30-year fol- low-up. Diabetes Care 2016; 39: 686–93.
25. Kovatchev BP. Metrics for glycaemic control: from HbA1c to continuous glu-cose monitoring. Nat Rev Endocrinol 2017; 13: 425–36.
26. Brazg RL, Klaff LJ, Parkin CG. Performance vari- ability of seven commonly used self-monitoring of blood glucose systems: clinical considerations for patients and providers. J Diabetes Sci Technol 2013; 7: 144–52.
27. Hirsch IB, Verderese CA. Professional flash continuous glucose monitoring with ambulatory glucose profile reporting to supplement A1C: rationale and practical implementation. Endocr Pract 2017; 23: 1333–44.